The ironworker from Pennsylvania, who searched for survivors and worked on the pile after 9/11, says that word belongs to those who died, not those who lived. The word belongs to his brother, Daniel, a firefighter killed in the North Tower collapse.

Libretti considers himself not a hero but an American. And as an American, he believes the government owes him protection.

“I just want to be taken care of the way I tried to take care of other people [on 9/11],” Libretti testified at a U.S. House of Representative subcommittee hearing held in Lower Manhattan last week.

Libretti suffers from chronic lung disease and post-traumatic stress disorder. He is unable to work, leaving his family with reduced income and no healthcare. He said he has attempted suicide.

Like many of the first responders who came to New York City from every state in the country, Libretti returns to New York for treatment. Some days he can’t face the bus trip of over 100 miles and misses his appointments. Reimbursement for his treatment has been spotty, forcing him to accrue credit card debt to take care of himself and his family.

“That’s my problem,” Libretti said. “But that problem was made by 9/11.”

The federal government has not adequately met the needs of responders like Libretti, elected officials and witnesses said last week. The hearing at Downtown’s federal courthouse focused on the Center for Disease Control’s decision in December to pull the plug on a health center that would have coordinated treatment for first responders nationwide.

Witnesses testified that the group most affected by the cancellation would be the national responders, who currently receive care through a program funded by the Red Cross. That funding will end in March, and these responders could face a gap in care. Their only choice would be to travel to New York City for treatment  not a viable option for many.

The cancellation could also jeopardize the monitoring and treatment programs in New York City, said James Melius, administrator for the New York State Laborers’ Health and Safety Trust Fund.

“We need a comprehensive solution to this problem over the next few months,” Melius said. “There’s definitely a crisis coming.”

Rep. Edolphus Towns, chairperson of the Government Management subcommittee, called the C.D.C.’s decision “baffling.”

“The [U.S. Department of Health and Human Services] program for 9/11 health care is one of the worst managed programs I’ve seen,” Towns said. “It is shameful.”

Rep. Jerrold Nadler said it was worse  that the programs are not the most mismanaged, but rather the most deliberately sabotaged.

“I am outraged to have to say again that the Bush administration has turned its back on the heroes of 9/11,” Nadler said.

The C.D.C. gave several reasons for canceling plans for the health center, including confusion about the proposal and lack of funding, Melius said. However, witnesses pointed to the $108 million the federal government recently allocated for 9/11 health, which would have fully funded the center.

The subcommittee, which includes Rep. Carolyn Maloney, invited the Department of Heath, but the agency declined to send a representative. Towns promised to go after e-mails and other records, with a subpoena if necessary. “We are not going to go away,” he said.

The Department of Health and Human Services did not comment.

Rep. Vito Fossella, a Republican, was also highly critical of Bush’s Health Department, saying the agency is “running and hiding” rather than stepping up to help those who risked their lives on 9/11.

Maloney and Nadler held a press conference Sunday at ground zero with several first responders, who also attended the state of the union address Monday night. The goal, Maloney said, is to convince President Bush to “do right by the heroes of 9/11.”

The Government Accountability Office released a report last July saying national services were lacking, and the situation has only gotten worse, said Cynthia Bascetta, director of healthcare at the G.A.O., at the hearing.

“The importance of covering the entire population that responded [on 9/11] cannot be overstated,” she said. Bascetta is worried that first responders will be more hesitant to put their lives on the line during future disasters, given this precedent.

Fraone was healthy when he arrived at the World Trade Center Sept. 16, 2001 with a FEMA Urban Search and Rescue Team. He worked 16-hour days on the pile, and soon had a chronic cough and trouble catching his breath. Once he returned to California, the battle to get healthcare was uphill and slow. The closest medical facility that would treat him was more than two hours away. The need for a coordinated national program, Fraone said, is overwhelming.

Kevin Mount, a retired Department of Sanitation worker who lives in Florida, agreed. Mount was healthy and just a few years away from retirement when he reported to ground zero on Sept. 12, 2001. He worked 14-hour shifts seven days a week with nothing more than a paper mask, first at the World Trade Center and later at the Fresh Kill landfill in Staten Island. His first day off was Thanksgiving, and his second was Christmas.

In February 2002, Mount went to the emergency room with a high fever and difficulty breathing. Pressure from his impacted sinuses later caused his left eardrum to collapse, leaving him with diminished hearing and a constant ringing in his ear. Mount was also psychologically overwhelmed by the knowledge that protective gear could have saved his health.

“I feel absolutely betrayed,” Mount said. “There was no reason why we should get sick.”

For cleaner, warmer air, Mount moved to Florida, but found that the doctors there did not have the specialty to treat him. He returns to New York several times a year for medical care.